This K-Award is designed to develop expertise for becoming an independent investigator in the study of clinical decision-making of child and adolescent psychiatrists (CAPs). This area is critical because of the demonstrated variability between CAPs regarding diagnosis leading to delays in appropriate treatment and diverse effects from inappropriate treatment. These problems have been found to occur in multiple settings with a range of diagnoses such as Attention Deficit Hyperactivity Disorder (ADHD) and Juvenile Bipolar Disorder (JBD). Surprisingly little research has been done to understand and improve CAPs' behavior, yet tools have been used in other areas of medicine to characterize and improve clinician behavior. Judgment and decision-making (JDM) studies have described how clinicians evaluate and weigh symptoms, arrive at a diagnosis and treatment. Investigators have created effective tools to improve these processes. The candidate's long-term goal is to apply JDM methods to a range of childhood psychopathology. For this award she will focus on the diagnosis of ADHD and JBD drawing on her experience in research on the diagnosis and treatment of childhood disorders. She will accomplish the goals of the K-award with 3 aims: i) To train to be an independent investigator in JDM in psychiatry in order to describe and improve the clinical practices of CAP; ii) To apply JDM to describe how CAPs make diagnostic decisions with children with JBD, ADHD, and comorbid disorders, iii) To use these results to help develop and pilot a human-centered diagnostic decision aid (DDA) to improve diagnostic accuracy in preparation for an R01 which will study its use in controlled studies. Subsequent research will apply JDM to other diagnostic and treatment issues. [unreadable] [unreadable]